Improving the Performance of Students on Serial OSCEs and Taking the Taiwan National OSCE-Experience from a Teaching Hospital

Abstract

Background: This study analyzes the performance of a group of students taking five objective structured clinical examinations (OSCE) in a teaching hospital. It explores the effectiveness of training plan with actual OSCE activities with respect to the improvement in the students’ clinical abilities. Methods: During the school year from July, 2012 to May, 2013, the clinical skill center held five OSCEs. The cohort of students (a total of 34 examinees)come from three different medical schools A,B,D in Taiwan ( Groups A, B, D) and foreign medical schools(Group C) were collected . With regards to the experience of participating in the OSCE before July, 2012: Group A had experienced it eight times; Group B one time, inside Group C, six members had no experience of OSCE and two had experience; Group D one time. Apart from Group D who had only attended the fourth and fifth OSCE, Groups A, B and C had attended the five OSCEs. Regarding the first four mock exams, three of them adopted six stations (four SP stations, two skill operating stations), and one had adopted 12 stations (eight SP stations, four skill operating stations). This study choosed the last third students of the first OSCE (Group L3O1), Which consists of one member from Group A, four from Group B and four from Group C. Their subsequent performance were analyzed and compared with the other students. Results: With the increased experience in the OSCE, the mean of the fifth OSCE of Group L301 is significantly higher than that of the fourth OSCE and the mean of the fourth OSCE is significantly higher than that of the first OSCE, indicating that Group L301 enjoyed significant progress in the OSCE. The performance of Group D in the fourth OSCE significantly fell behind, which is similar to the performance of Group L301 of the first OSCE which significantly fell behind that of the other groups. However, the members of Group D in the fifth OSCE had no significant changes compared with the members of Groups A, B and C. This study cannot exclude completely the influence of small study group, test format familiarity and the influence from the degree of test difficulty on the performance. Conclusions: The results of this study show that a number of field OSCEs in teaching hospital could effectively assist students to enhance their OSCE performance and lack of test format familiarity is an important factor for the poor performance. The clinical skills training program in the teaching hospital, as illustrated in this study, is in line with modern medical educational thinking and the clinical skill training mode of national exam policies.